Lesión de Morel-Lavallée: diagnóstico y tratamiento con técnicas de imagen

Objectives

We aim to review the characteristics of Morel-Lavallée lesions and to evaluate their treatment.

Influence de la morphologie,de VO2max et du coût énergetique sur la performance en natation chez de jeunes nageurs

Aim. – Define the determining factors of young swimmers’ performance on a 400 m.Materia1 and methods. – Eleven people who were 12.4 (±0.53) years of age and who swam 7.5 to 8.5 hours a week took part in this study. Height, weight, hidrostatic lift and surface area were measured. Maximal oxygen consumption was calculated at the end of a maximal performance on a 400 m crawl.Results. – The maximal oxygen consumption equaled to 2.19 l min^–1 (±0.38) for a maximal aerobic velocity of 1.19 m s^–1 (±0.03) and a performance of 5 min 35 s (±10 s) on a 400 m crawl. The values of the energy cost at 0.9, 1 and 1.1 m s^–1 were respectively of 29.27 (±3.13), 30.25 (±3.68) and 32.91 (±3.59) ml m^–1. The differences of performance on a 400 m crawl were accounted for by biometric characteristics or by the energy cost at 0.9 and 1 m s^–1. However, the performance on a 400 m crawl was correlated to the energy cost at 1.1 m s^–1 (r = 0.82 ; P < 0.01) and to the maximal oxygen consumption (r = 0.87; P < 0.001).Conclusion. – This study proved that there was a very strong relationship between performance and maximal oxygen consumption in young swimmers.     

Aplicaciones de la técnica de difusión por resonancia magnética en el manejo de la patología tumoral osteomuscular

Magnetic resonance imaging (MRI) is the technique of choice in the diagnosis, staging, and follow-up of musculoskeletal tumors. Diffusion imaging is a new functional MRI technique that provides information that is complementary to that obtained in conventional MRI sequences. Diffusion imaging has proven useful in different clinical situations like the characterization of disease involving the bone marrow (bone metastases, benign fractures, or hematological disease), the evaluation of tumors of the bones and soft tissues, and the monitoring of the response to treatment in patients with tumors. The aim of this article is to review the diffusion technique in MRI and its current clinical applications in the management of musculoskeletal tumors.     

Radiografía de tórax pediátrica en la era COVID

BackgroundAn infectious disease caused by a new type of coronavirus that can manifest as an acute respiratory infection was discovered in China in mid-December 2019 and soon spread throughout the country and to the rest of the world. Although chest X-rays are the initial imaging technique of choice for low respiratory infections with or without dyspnea, few articles have reported the radiologic findings in children with COVID-19.ObjectiveTo describe the clinical, laboratory, and chest X-ray findings in pediatric patients with signs and symptoms of respiratory infection attended at our hospital in March 2020. To analyze the frequency of COVID-19 compared to other respiratory infections, and to describe the radiologic manifestations of COVID-19 in pediatric patients.Material and methodsThis cross-sectional observational study included all children with clinical manifestations of respiratory infection (fever, rhinorrhea, cough, and/or dyspnea) that required chest X-rays in our hospital between March 1 and March 31.ResultsA total of 231 pediatric patients (90 (39%) girls and 141 (61%) boys; mean age, 4 y, range 1 month – 16 years) underwent chest X-rays for suspected respiratory infections. Most (88.4%) had mild symptoms; 29.9% had a family member positive for COVID-19 with symptoms similar to those of the patient. Nasal and/or throat swabs were analyzed for SARS-CoV-2 with PCR in the 47 (20.3%) children who presented at the emergency department; 3 (6.3%) of these were positive. Microbiological analyses were done in 85 (36.8%) of all patients, finding infections due to pathogens other than SARS-CoV-2 in 30 (35.3%). One of the patients with a PCR positive for SARS-CoV-2 had urine infection due to E. coli and blood culture positive for S. viridans. Abnormalities were observed on X-rays in 73.2% of the patients. Peribronchial thickening was the most common abnormal finding, observed in 57% of patients. Parenchymal consolidations were observed in 38.5%, being bilateral in 29.2% and associated with pleural effusion in 3.3%. The interstitial lines were thickened in 7.3%, and 7.3% had ground-glass opacities.ConclusionDuring March 2020, COVID-19 and other symptomatic respiratory infections were observed. The radiologic pattern of these infections is nonspecific, and chest X-rays alone are insufficient for the diagnosis. Children with clinical manifestations compatible with COVID-19 (with or without PCR confirmation of infection by SARS-CoV-2) had mild symptoms and most did not require admission or invasive mechanical ventilation. In a context of community transmission, the absence of a known epidemiological antecedent should not be a contraindication for PCR to detect SARS-CoV-2.     

Rentabilidad diagnóstica de la biopsia con aguja gruesa guiada por técnicas de imagen del mesenterio y del peritoneo

Objective

To evaluate the diagnostic performance of imaging-guided core needle biopsy of nodules and diffuse infiltration of the omentum or of the peritoneum.

Cáncer de esófago: particularidades anatómicas,estadificación y técnicas de imagen

Cancer of the esophagus is a tumor with aggressive behavior that is usually diagnosed in advanced stages. The absence of serosa allows it to spread quickly to neighboring mediastinal structures, and an extensive lymphatic drainage network facilitates tumor spread even in early stages. The current TNM classification, harmonized with the classification for gastric cancer, provides new definitions for the anatomic classification, adds non-anatomic characteristics of the tumor, and includes tumors of the gastroesophageal junction. Combining endoscopic ultrasound, computed tomography, positron emission tomography, and magnetic resonance imaging provides greater accuracy in determining the initial clinical stage, and these imaging techniques play an essential role in the selection, planning, and evaluation of treatment. In this article, we review some particularities that explain the behavior of this tumor and we describe the current TNM staging system; furthermore, we discuss the different imaging tests available for its evaluation and include a diagnostic algorithm.     

Hallazgos en la tomografía computarizada de tórax en las fases evolutivas de la infección por SARS-CoV-2

ObjectiveTo compare the findings on chest computed tomography (CT) in patients with COVID-19 during different phases of the disease and to evaluate the reproducibility of a visual radiologic score for estimating the extent of lung involvement.MethodsWe retrospectively reviewed chest CT studies from 182 patients with RT-PCR findings positive for SARS-CoV-2. Patients were classified according to the time elapsed from the onset of symptoms, as follows: early (0-4 days), intermediate/progressive (5-9 days), or advanced (≥10 days). We analyzed the frequency of each radiologic finding, as well as the pattern, appearance, and predominant distribution of lung involvement. A visual tomographic score (range, 0-25) was used to estimate the extent of involvement in each lobe and in the total lung volume.ResultsThe predominant CT finding was the ground-glass pattern (n=110; 60.4%), the most common distribution was peripheral (n = 116; 66.7%), and the most prevalent appearance was typical (n=112; 61.5%). The halo sign was seen most frequently in the early phase (25%), whereas ground-glass opacities were more common in the intermediate/progressive and advanced phases. The median severity score was 10 (IQR: 5-13), and the scores increased as the disease progressed. The interobserver agreement (kappa) was 0.92 for the appearance, 0.84 for the distribution, 0.70 for the predominant pattern, and 0.89 for the visual score.ConclusionThe CT findings in patients with COVID-19 vary with the course of the infection. The proposed visual radiologic score is a simple, reproducible, and reliable tool for assessing lung involvement in COVID-19 pneumonia.     

Radiografía lateral de tórax. Anatomía radiográfica

Lateral chest views constitute an essential part of chest X-ray examinations, so it is fundamental to know the anatomy on these images and to be able to detect the variations manifested on these images in different diseases. The aim of this article is to review the normal anatomy and main normal variants seen on lateral chest views. For teaching purposes, we divide the thorax into different spaces and analyze each in an orderly way, especially emphasizing the anatomic details that are most helpful for locating lesions that have already been detected in the posteroanterior view or for detecting lesions that can be missed in the posteroanterior view.     

Guía SEOM-SERAM-SEMNIM sobre el empleo de las técnicas de imagen funcional y molecular en el cáncer de pulmón no microcítico avanzado

Imaging in oncology is an essential tool for patient management but its potential is being profoundly underutilized. Each of the techniques used in the diagnostic process also conveys functional information that can be relevant in treatment decision making. New imaging algorithms and techniques enhance our knowledge about the phenotype of the tumor and its potential response to different therapies. Functional imaging can be defined as the one that provides information beyond the purely morphological data, and include all the techniques that make it possible to measure specific physiological functions of the tumor, whereas molecular imaging would include techniques that allow us to measure metabolic changes. Functional and molecular techniques included in this document are based on multi-detector computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET), magnetic resonance imaging (MRI), and hybrid equipments, integrating PET with CT (PET/CT) or MRI (PET-MRI). Lung cancer is one of the most frequent and deadly tumors although survival is increasing thanks to advances in diagnostic methods and new treatments. This increased survival poises challenges in terms of proper follow-up and definitions of response and progression, as exemplified by immune therapy-related pseudoprogression. In this consensus document, the use of functional and molecular imaging techniques will be addressed to exploit their current potential and explore future applications in the diagnosis, evaluation of response and detection of recurrence of advanced NSCLC.     

Corrélations entre scores au questionnaire de la Société française de médecine du sport et concentrations de cortisol et testostérone salivaires lors du suivi d’une équipe de rugby de haut niveau

Objective. – To carry out the follow-up of 21 high level rugby players by means of the psycho-comportmental questionnaire of the “French Society of Sports Medicine” (SFMS), of the salivary testosterone (T) and cortisol (C) levels and of their ratio T/C during the sporting season.Materials and methods. – The players provided three samples of saliva, at awakening (8 am), just before the lunch (11 am), and at 17 pm in order to assay cortisol and testosterone. The first measurements were done at the beginning of season (T1), 12 weeks (T2) and 24 weeks (T3) after T1. At the same periods, they completed the 54 items of the SFMS questionnaire which allows to give a score (from 1 to 54) proportional to the state of tiredness of the subject. The performance of the team was estimated from the ratio of victories to the number of matches played over the season.Results and discussion. – The increase in the score obtained with the SFMS questionnaire and the variations of the hormonal levels during the season seem to reflect a normal adaptation phenomenon to the training load, a fact which is confirmed by the maintenance of the same level of performance of the team throughout the season. This study permitted to highlight the parallel evolutions between the psycho-comportemental index (score) and the hormonal markers of the state of tiredness. Thus, it appears that the SFMS questionnaire is an interesting and easy to employ tool to evaluate the state of tiredness (or reciprocally of form) of a sportsman during the course of the sporting season.